Iowa is tweaking its new state-funded family planning program that excludes abortion providers such as Planned Parenthood by restoring some eligibility to a large hospital system.

Some of UnityPoint Health's hospitals and clinics could soon participate again in the state's family planning program under a budget bill passed in the final days of the legislative session.

The change, which needs approval from Republican Gov. Kim Reynolds, allows UnityPoint's affiliated providers to sign up individually for the program by submitting paperwork confirming they don't perform abortions.

UnityPoint was kicked out of the program because some of its locations perform abortions in cases where a fetus is not expected to be viable.

After Iowa Republicans passed legislation to launch a state-funded family planning program last July, UnityPoint representatives argued some of its health care providers should still be able to participate because those stand-alone facilities don't perform abortions.

Planned Parenthood said the move highlights GOP lawmakers' intention to defund its organization. The local Planned Parenthood affiliate closed four of its 12 clinics after the law excluded them from the program, which covers services such as birth control exams and counseling as well as limited testing and treatment for sexually transmitted diseases.

"While we are glad for folks in Iowa who are attempting to access reproductive health care right now that they will have a couple more options through this tweak in the new family planning program, what it makes clear is that this whole program was set on excluding Planned Parenthood," said Erin Davison-Rippey, a representative for Planned Parenthood of the Heartland.

Sen. Mark Costello, an Imogene Republican involved in adding the exemption, said the decision was made because some lawmakers initially believed the new law would not impact UnityPoint affiliates.

"When it got applied differently, we just wanted to correct that this year," he said.

State documents show Republican lawmakers were warned last spring that their legislation — which ultimately gave up millions of federal Medicaid dollars to create a state-run family planning program that excludes abortion providers such as Planned Parenthood — would impact UnityPoint.

"This 'fetal anomaly' exception was not contained in the final bill that was passed and enrolled," an Iowa Department of Human Services official wrote last summer to a UnityPoint executive.

The department official noted lawmakers knew the legislation would affect UnityPoint's participation.

The University of Iowa hospital and clinic system also performs limited abortions and remains barred from the program.

UnityPoint spokeswoman Teresa Thoensen said in an email that the Legislature's latest action "was an essential component to ensure continuation of care to our patients and communities." She declined to answer questions.

Iowa lawmakers have agreed to spend about $3 million annually for its new family planning program, up from a few hundred thousand dollars under the Medicaid match setup. Preliminary data shows the state has paid just $285,000 in claims to health providers for a portion of this budget year, and there's a marked decline in patients and participating health care providers. State officials say the data is incomplete. Even before the switch, no state or federal money paid for abortions in Iowa.

Iowa is one of three states — along with Missouri and Texas — that have given up Medicaid dollars in recent years to run state-funded family planning programs that exclude abortion providers. Iowa appears to be the first to bring excluded organizations back into the fold, according to the Guttmacher Institute, a national research group that supports abortion rights, though each state runs their programs differently.

Reynolds has several weeks to approve UnityPoint's exemption or veto it. The governor recently approved a ban on most abortions in Iowa once a fetal heartbeat can be detected, which is around six weeks of pregnancy. The ban is expected to face litigation that could put it on hold before it takes effect July 1.